Cialis (tablets of 2.5 mg, 5 mg and 20 mg) - instructions for use, feedback, analog, side effects of drugs and indications for the treatment of erectile dysfunction and restore potency in men. The composition and the interaction with alcohol
On this page, published detailed instructions on the use of Cialis. The available dosage forms of the drug (2.5 mg tablets, 5 mg and 20 mg) and its analogs. The information about the side effects that can cause Cialis, about the interaction with other drugs. In addition to information on diseases, treatment and prevention of which is prescribed drug (erectile dysfunction and restore the potency), painted in detail algorithms reception possible dosage for men. Abstract Cialis supplemented by reviews of patients and physicians. The composition and interaction of the drug with alcohol.
Instructions for use and dosage regimen
The drug is taken orally, regardless of the meal.
The recommended maximum dose of Cialis is 20 mg. The maximum recommended frequency of administration - one time per day.
Cialis take at least 16 minutes before anticipated sexual activity.
Patients can perform attempt intercourse at any time within 36 hours after dosing in order to determine the optimal response time to the drug.
Method of production
Tablets, film-coated 2.5 mg, 5 mg and 20 mg.
Cialis - a drug for the treatment of erectile dysfunction. It is a reversible selective inhibitor of specific phosphodiesterase type 5 (PDE5) cGMP. When sexual stimulation causes local release of nitric oxide, inhibition of PDE5 tadalafil leads to increased levels of cGMP in the cavernous body of penis. The result is relaxation of smooth muscles of arteries and blood flow to the tissues of the penis that causes erections. Tadalafil (the active ingredient of Cialis) has no effect in the absence of sexual stimulation.
Studies in vitro have shown that tadalafil is a selective inhibitor of PDE5. PDE5 - an enzyme found in corpus cavernosum smooth muscle, vascular smooth muscle in internal organs, skeletal muscle, platelets, kidney, lung, cerebellum.
Cialis improves erection and the possibility of successful sexual intercourse.
The drug acts during 36 hours. The effect is already apparent 16 minutes after taking the drug in the presence of sexual arousal.
Tadalafil in healthy individuals does not cause significant changes in systolic and diastolic blood pressure compared with placebo in the prone position (mean maximum decrease in blood pressure of 1.6 / 0.8 mm Hg, respectively) and standing (mean maximum decrease in blood pressure of 0.2 / 4.6 mm Hg .st. respectively). Tadalafil does not cause significant changes in heart rate.
Tadalafil does not cause changes in the recognition of color (blue / green), due to its low affinity to the PDE6. In addition, no marked effect on visual acuity tadalafil, electroretinogram, intraocular pressure and pupil size.
In order to evaluate the effect of a daily intake of at tadalfila spermatogenesis have been several studies. None of the studies was not observed undesired effects on sperm morphology and motility. In one study showed a reduction in the average sperm concentration relative to placebo. Reduced sperm concentration was associated with a higher frequency of ejaculation. Furthermore, tadalafil does not cause undesirable changes of testosterone, LH and FSH in the blood plasma, as compared to placebo.
Once inside Cialis is rapidly absorbed. The rate and extent of absorption is unaffected by food. Time dosing (morning or evening) had no clinically significant effect on the rate and extent of absorption.
At therapeutic concentrations, 94% tadalafil bound to plasma proteins. In healthy persons less than 0.0005% of the administered dose was found in semen.
Tadalafil is excreted mainly in the form of inactive metabolites, mainly in the feces (about 61%) and to a lesser extent in the urine (about 36%).
concomitant use of drugs containing any organic nitrates;
use in patients under the age of 18 years;
hypersensitivity to the drug.
Tadalafil + auxiliaries.
Precautions should be prescribed to patients with severe hepatic insufficiency (Class C of Child-Pugh), since the data of controlled clinical trials on the safety and efficacy of Cialis in this group of patients are not available.
Care should be taken in the appointment of Cialis to patients taking α1-blockers such as doxazosin, as the simultaneous use, in some cases may lead to symptomatic hypotension. In clinical pharmacology studies in 18 healthy volunteers who received a single dose of tadalafil showed no symptomatic hypotension while the introduction of alpha-1-blocker tamsulosin.
Sexual activity is a potential risk for patients with cardiovascular diseases. Therefore, treatment of erectile dysfunction, including using Cialis, you should not hold for men with heart disease, in which sexual activity is not recommended.
It should be taken into account the potential risk of complications during sexual activity in patients with diseases of the cardiovascular system: myocardial infarction within the last 90 days; unstable angina or angina occurring during sexual intercourse; Chronic heart failure (functional class 2 or higher on the classification of NYHA), which developed during the last 6 months; uncontrolled heart rhythm disorder; hypotension (blood pressure less than 90/50 mm Hg), or uncontrolled hypertension; stroke, myocardial in the last 6 months.
Caution should be used Cialis for patients with severe renal insufficiency (creatinine clearance less than 30 ml / min), renal failure, moderate (creatinine clearance 31 to 50 mL / min) and in patients with a predisposition to priapism (eg, sickle at cell anemia, multiple myeloma or leukemia), or in patients with anatomical deformation of the penis (for example, angulation, cavernous fibrosis or Peyronie's disease).
There are reports of occurrence of priapism PDE5 inhibitors, including Cialis. The patient should be informed of the need for immediate treatment to the doctor in the event of an erection, continued for 4 hours or more. Delays in treatment of priapism leads to tissue damage of the penis, as a result of this loss may occur long-term potency.
The safety and efficacy of a combination of Cialis with other treatments for erectile dysfunction have not been studied. Therefore, the use of such combinations is not recommended.
As with other PDE5 inhibitors, tadalafil has systemic vasodilator properties, which may lead to a transient decrease in blood pressure. Before the appointment of Cialis, physicians should carefully consider the question - not whether the patients with their existing cardiovascular disease subjected adversely affected by such vasodilatory effects.
Nearterialnaya anterior ischemic optic neuropathy (NAPION) is the cause of visual impairment, including total loss of vision. There are rare post-marketing reports of cases of NAPION, the time associated with taking PDE5 inhibitors. At the present time it is impossible to determine whether there is a direct link between the development and NAPION taking PDE5 inhibitors or to other factors. Physicians should advise patients in the event of a sudden loss of vision stop taking tadalafil and seek medical advice. Patients should be warned that in people who have had NAPION increased risk of recurrence of the condition.